All posts by Kit Case

L&I Proposes No Increase in Workers’ Comp Rate for 2013

How Much of the Savings Came Out of the Pockets of Workers?

 

September 17, 2012: The Washington State Department of Labor & Industries (L&I) today announced it is proposing no increase in the average rate for workers’ compensation insurance. If adopted, this would be the second straight year with no increase in workers’ comp rates.

 

“Had the Governor and the Legislature not adopted the 2011 reforms, I wouldn’t be making this proposal today,” said L&I Director Judy Schurke. “In fact, without those reforms, we would be facing a rate increase. Instead, we’re able to keep rates down for Washington’s businesses and workers.”  Savings due to reforms are beating expectations. L&I is now projecting the reforms passed in 2011 will save $1.5 billion over four years, $300 million higher than originally estimated.

While the reforms play an important part in lowering costs, Schurke pointed to additional factors responsible for lower costs in 2013, including:

  • Fewer claims in high hazard industries like construction are resulting in fewer long-term disabilities;
  • Overall claim frequency, or the number of claims per 100 workers, has gone down by 6.2 percent;
  • L&I has held medical cost growth below 4 percent over the past five quarters and expects continuing to do so in 2013 with the new provider network and health technology assessments;
  • L&I is resolving claims more quickly as a result of Lean and other improvements.

Today’s proposal would mean an additional $82 million is placed in the State Fund reserves by the end of 2013. In the past, the State Auditor issued strong warnings about the consequences of maintaining inadequate reserves. Schurke also acknowledged the reserves are critically low by industry standards due to increased liabilities, investment losses and drawing down the reserves to hold down rates during the recession.

The Workers Compensation Advisory Committee (WCAC), which has been working with L&I on a plan to rebuild the reserves, endorsed L&I’s proposal to hold rates steady in 2013 and begin rebuilding the reserves. Washington is the only state where workers pay a substantial portion of premiums. Workers will pay about 24 percent of the premiums in 2013. The proposal to keep rates flat in 2013 is an average for all Washington employers. Individual employers may see their rates go up or down, depending on their recent claims history and changes in the frequency and cost of claims in their industry.

Every year in Washington, about 100,000 claims are filed for medical costs and lost wages due to work-related injuries, illnesses and deaths. Each year, L&I must review premium rates and make adjustments to cover the anticipated costs of claims that occur in the next year.

Public hearings on the proposed rates will be held in:

  • Tukwila, Oct. 23, 10 a.m., L&I office.
  • Bellingham, Oct. 23, 1 p.m., Public Library Lecture Room.
  • Spokane, Oct. 24, 10 a.m., CenterPlace Event Center.
  • Richland, Oct. 25, 10 a.m., Community Center Activity Room.
  • Tumwater, Oct. 26, 10 a.m., L&I Auditorium.
  • Vancouver, Oct. 29, 10 a.m., Red Lion at the Quay, Quayside Portside Room.

More information regarding the rate proposal is available at www.Rates.Lni.wa.gov. The final rates will be adopted in early December and go into effect Jan. 1, 2013.

 

“Evidence-based coverage decisions have reduced unnecessary care and avoided $27 million in annual costs.”  (Emphasis added.)

 

Translation: Denying requested treatment costs the State less than authorizing it. – Ed.

 

Background Information:

  • On average, workers’ comp rates have increased less than 3 percent per year since 2006. This is lower than L&I’s anticipated rate of medical and wage inflation.
  • When calculated as a percentage of payroll, which is how rates are calculated in other states, the proposed 2013 overall rates would be equal to a 2.2 percent reduction.
  • Without savings from the reforms, the 2013 break-even rate would have been about 4 percent instead of minus 4.2 percent. The break-even rate is the amount needed to cover projected costs for the next year. L&I will use the difference between the break-even rate and zero – $82 million – to begin restoring the workers’ comp reserves.
  • The elements of the 2011 workers’ compensation reforms have various effective dates, beginning in 2011 and continuing through 2013. Savings estimates are now at $1.5 billion over four years, with continued savings in future years.
  • As a result of Lean and other initiatives, we are seeing a downward trend in the duration of younger claims.
  • L&I has held medical cost growth below 4 percent over the past five quarters and estimates doing so in 2013 with the new provider network and health technology assessments. Our medical costs are 26 percent less than the average workers’ comp program in the U.S.
  • Evidence-based coverage decisions have reduced unnecessary care and avoided $27 million in annual costs.
  • In 2011, the number of long-term disability claims per 100 workers fell by 6.2 percent, the largest decline since 1995. Long-term disabilities account for 85 percent of workers’ comp claim costs.
  • When hiring picks up in construction and other high-risk industries, we can expect an increase in long-term disability injuries. That’s why it’s important to examine safety practices now and be ready to bring more people back to work safely.
  • Workers’ comp insurance rates are based on the likelihood of an injury. Rates for almost half of the job classifications will change 1 percent or less next year.

Misdiagnosed Worker Can Amend The Cause Of Injury More Than 2 Years Later

Today’s post comes from guest author Matthew Funk from Pasternack Tilker Ziegler Walsh Stanton & Romano. Washington State claims can include conditions diagnosed after the initial filing of a claim, as well. Please feel free to contact us to discuss the specifics of your case if you are facing a similar situation.

The Appellate Division Third Department issued a decision (Searchfield v. Lowe’s Home Centers) that is interesting case because it pertains to the establishment of an injury that was originally misdiagnosed.

  • In October 2005, an employee was injured at work while lifting a hot water heater. As a result of the injury the employee went to the emergency room. He was diagnosed by an emergency room physician with myofascial strain of the legs and hips.
  • A November 2005 physician’s report diagnosed the claimant with hip/thigh sprain and sciatica. The later medical reports focused on the groin, lower back and leg pain.
  • In July 2006, a Law Judge established the claim for a work related injury to the claimant’s lower back. However, the employee continued to report worsening symptoms in his hip area.
  • In 2009, the claimant saw an orthopedic surgeon. The doctor performed a MRI of the right hip. The MRI revealed a right hip labral tear that required surgury. According to the surgeon the claim was originally misdiagnosed and the claimant had, in fact, sustained injuries to his right hip as a result of the October 2005 accident.
  • The claimant applied for a hearing to amend the claim for the right hip.
  • The Judge ruled that the right hip claim was time barred (pursuant to Workers’ Compensation Law Section 28). This states that a claim for a causally related condition must be made within two years of the date of accident.
  • On appeal the Board Panel reversed and the Appellate Division affirmed the Board Panel.

The Appellate Division stated that the early medical reports reflect initial concerns relating to the claimants hips. Also, there was supporting medical evidence that the claimant’s ongoing pain was the result of a labral tear in the right hip, a condition which is often misdiagnosed as a low back injury. The Court went on to add that the claimant could not have filed a claim for a causally related right hip injury at the time of the accident because it was not properly identified and diagnosed.

This case is important as it allowed the amendment of a claim for a serious injury that misdiagnosed early on in the case. You can find the entire court decision here.

DLI’s New Stay at Work Program

DLI Notice of Workshops on the Stay at Work Program

The following was released by DLI as a public notice:

The Department of Labor & Industries (DLI) has reimbursed more than 1,000 employers almost $5.5 million to help retain injured workers in light duty jobs, but many businesses around the state remain uncertain how the program can benefit them.  To help, L&I is holding workshops across the state to explain the new Stay at Work program, which provides up to half of a worker’s base wages for up to 66 days or $10,000 per claim if the employer places their injured workers in light-duty or transitional work. 

The free, 90-minute workshops provide an overview of the program, explain how to apply for the reimbursements, the requirements, benefits, and how participation can help reduce claim costs for participating businesses. To sign up for a workshop or learn more about the program, visit www.StayatWork.Lni.wa.gov, or call 1-866-406-2482.

The current workshop schedule is:

  • Yakima – Sept. 11 from 9 -10:30 a.m. and 2 – 3:30 p.m., 15 W. Yakima Ave., Suite 100.
  • Everett – Sept. 13, from 10 ­- 11:30 a.m., 729 100th St. SE.
  • Kelso – Oct. 8, from 9 – 10:30 a.m. and 2 – 3:30 p.m., 711 Vine St.  
  • Everett – Nov. 8, from 10 – 11:30 a.m., 729 100th St. SE.
  • Spokane – Dec. 11, 9 – 10:30 a.m. and 2 – 3:30 p.m., 901 N. Monroe St., Suite 100.
  • Tukwila – Dec. 13 from 10 – 11:30 a.m., 12806 Gateway Drive South.

Ultimately, Stay at Work is projected to save $32 million annually by keeping workers on the job and reducing the chance of long-term disability. And getting injured workers out of their homes and back in the workplace has additional benefits – studies show that people off work longer than six months have only a 50 percent chance of ever returning to their job, while those who get back to work enjoy faster recovery times and improved lifelong health.

 

Trust your instincts – if things don’t feel right, they likely are not right.  Seek guidance prior to accepting or declining an offer of light-duty employment.

 

DLI Information for Injured Workers

The following is excerpted from the DLI website section on this topic:

The Department of Labor and Industries will reimburse your employer 50% of your base wages if they are able to find an eligible light-duty job for you. DLI will also cover expenses such as training and tools related to the light-duty job. If your employer offers you a job that your doctor approves and you choose not to accept it, you won’t be eligible to receive time-loss compensation. However, you aren’t required to accept any job that would exceed the restrictions set by your doctor.

 

DLI offers this cheery video – one of three – on the topic of the Stay at Work Program:

 

 

Our Perspective

As the DLI notice, above, indicates, it seems that many employers are not aware of the benefits available to them under this relatively new program, including significant incentives to offer accommodation to injured workers. 

We have seen both success stories and nightmares surrounding light-duty job offers from employers.  When applied appropriately and administered with a sense of caring, a light-duty job can be beneficial to an injured worker.  Returning to work can improve morale, maintain healthcare benefits for the worker and/or their families, and assist with a gradual return to full duties.  However, some offers of light-duty work are engineered to drive a worker to quit after accepting the job, which can remove the worker’s eligibility for time loss compensation.  Or, in other cases, the job may start out as light duty but the tasks requested may slide back towards regular duty levels, either intentionally or through habit, leading to increased symptoms or new injuries.

Trust your instincts – if things don’t feel right, they likely are not right.  Seek guidance prior to accepting or declining an offer of light-duty employment.

BP Cherry Point refinery cited for willful and serious workplace safety violations, fined $81,500

Image © BP p.l.c.

The Washington State Department of Labor & Industries (DLI) has cited the BP Cherry Point petroleum refinery in Blaine for six violations, including one “willful violation,” of workplace safety and health rules related to management of pipeline and refinery processes. The proposed penalties total $81,500.

 

A willful violation is the most significant civil classification that can be issued.

 

A willful violation is the most significant civil classification that can be issued. It is used when DLI alleges that the violation was committed with intentional disregard or plain indifference or substitution of judgment with respect to worker safety and health regulations.

DLI began the inspection in February after a major fire caused the refinery to shut down for a period of time. One employee was nearby when the fire erupted, but he was able to escape without harm.

The fire occurred when a corroded “deadleg” pipe ruptured. Deadlegs are pipes that aren’t often used but still must be monitored for integrity for when they are needed to carry material used in the refining process.

DLI cited the company for a “willful” violation for not ensuring that inspection and testing procedures for process piping followed recognized and generally accepted good engineering practices for all deadleg piping circuits. The proposed penalty for the willful violation is $65,000.

The five additional violations cited were for failing to comply with Process Safety Management standards, the requirements for managing hazards associated with processes that use highly hazardous chemicals.

The company has until Sept. 13 to appeal the citation.  A copy of the citation is available upon request.

For more information about this or other DLI news, click here.

Are You Suffering From Symptoms Of Chronic Stress? Take the Stress Test!

Signs of Chronic Stress:

Cognitive symptoms

•          Memory problems

•          Inability to concentrate

•          Poor judgment

•          Pessimistic approach or thoughts

•          Anxious or racing thoughts

•          Constant worrying

Emotional symptoms

•          Moodiness

•          Irritability or short temper

•          Agitation, inability to relax

•          Feeling overwhelmed

•          Sense of loneliness and isolation

•          Depression or general unhappiness

Physical symptoms

•          Aches and pains

•          Diarrhea or constipation

•          Nausea, dizziness

•          Chest pain, rapid heartbeat

•          Loss of sex drive

•          Frequent colds

Behavioral symptoms

•          Eating more or less

•          Sleeping too much or too little

•          Isolating oneself from others

•          Procrastinating or neglecting responsibilities

•          Using alcohol, cigarettes, or drugs to relax

 

Take the Stress Test for Adults:

Thomas Holmes and Richard Rahe in 1967, examined the medical records of over 5,000 medical patients as a way to determine whether stressful events might cause illnesses. Patients were asked to tally a list of 43 life events based on a relative score. A positive correlation was found between their life events and their illnesses.

Their results were published as the Social Readjustment Rating Scale (SRRS), known more commonly as the Holmes and Rahe Stress Scale.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Note: the table, below, is from the Wikipedia page on this subject.  For a fee of $5.00, you can go directly to Dr. Rahe’s website and obtain the full test materials as well as background information and details of this and other products and services available.

To measure stress according to the Holmes and Rahe Stress Scale, the number of “Life Change Units” that apply to events in the past year of an individual’s life are added and the final score will give a rough estimate of how stress affects health.

Life event Life change units
Death of a spouse 100
Divorce 73
Marital separation 65
Imprisonment 63
Death of a close family member 63
Personal injury or illness 53
Marriage 50
Dismissal from work 47
Marital reconciliation 45
Retirement 45
Change in health of family member 44
Pregnancy 40
Sexual difficulties 39
Gain a new family member 39
Business readjustment 39
Change in financial state 38
Death of a close friend 37
Change to different line of work 36
Change in frequency of arguments 35
Major mortgage 32
Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Child leaving home 29
Trouble with in-laws 29
Outstanding personal achievement 28
Spouse starts or stops work 26
Begin or end school 26
Change in living conditions 25
Revision of personal habits 24
Trouble with boss 23
Change in working hours or conditions 20
Change in residence 20
Change in schools 20
Change in recreation 19
Change in church activities 19
Change in social activities 18
Minor mortgage or loan 17
Change in sleeping habits 16
Change in number of family reunions 15
Change in eating habits 15
Vacation 13
Christmas 12
Minor violation of law 11

Score of 300+: At risk of illness.

Score of 150-299+: Risk of illness is moderate (reduced by 30% from the above risk).

Score 150-: Only have a slight risk of illness.

 

Recommended methods for relieving chronic stress include exercise (which can be modified to accommodate physical restrictions after an injury), meditation, music therapy, breathing techniques, and such simple things as companionship – from a pet, friend or family member.

 

What’s so dangerous about hotel room cleaning? It turns out, a lot.

Today’s post comes from guest author Edgar Romano from Pasternack Tilker Ziegler Walsh Stanton & Romano.

Hotel housekeeping may not seem dangerous, but it can be grueling physical labor. A recent study published by the National Institute for Occupational Safety and Health reported that tasks including dusting, vacuuming, changing linens, making beds, and scrubbing bathrooms may lead to a range of injuries. Some of the most common ones include: Continue reading What’s so dangerous about hotel room cleaning? It turns out, a lot.

Drug Watch: Osteoporosis Drugs Are Giving Women Severe Complications

Today’s post comes from guest author Brenda Fulmer from Pasternack Tilker Ziegler Walsh Stanton & Romano.

Post-menopausal women welcomed the class of drugs called “bisphosphonates,” which purportedly increase bone density by slowing the body’s natural turnover of bone cells and were touted as a safe and effective treatment for osteoporosis and osteopenia. Bisphosphonates are also widely used to treat both male and female patients whose cancer has spread to their bones and by patients who have a progressive bone disease called Paget’s disease.

Many patients who are being prescribed “bisphosphonates” for the treatment and prevention of osteoporosis are unaware of any risks associated with the use of such drugs.

Popular bisphosphonate drugs and their manufacturers include:

Fosamax is also available as the generic drug, alendronate. The drugs are available as pills as well as injections, and may be taken daily, several times per week, monthly, or event annually.

Patients who took these popular osteoporosis drugs have suffered severe bone fractures due to a weakening in bone structures caused by the drugs.

In a sad irony, patients who took these popular osteoporosis drugs in hopes of improving their bone health have actually suffered severe bone fractures, such as atypical femur fractures, due to a weakening in bone structures caused by the drugs. In addition, these bisphosphonate drugs have been linked with Continue reading Drug Watch: Osteoporosis Drugs Are Giving Women Severe Complications

Unsafe Workplaces Equal More Injuries.

Today’s post comes from guest author Tom Domer from The Domer Law Firm.

Washington State has a similar program for filing claims of discrimination when a worker is punished for reporting unsafe work conditions. Contact one of us to discuss your case if you have suffered such discrimination.

The connection between unsafe workplaces and the increased frequency of work injuries seems like a no brainer. A study released by NCCI Holdings indicated worker’s compensation claims rose by 3% during 2010 (the first rise in frequency in over a dozen years). The study attributed the increased frequency to several factors

Because of these repeat violations,OSHA cited United Contracting and placed the firm on its “Severe Violator Enforcement Program”

including increases in employment since the onset of the recession in 2008, workers possibly being less fearful of losing their jobs for filing claims, and a lack of light duty jobs to which injured workers could return because of the poor economy.

One factor not referenced is the connection between increasingly unsafe work environments and work injuries. Two recent news stories in Wisconsin underscored this connection. OSHA fined a Wisconsin contractor $150,000

for violations while working on two bridges along highways in Wisconsin. The violation is more alarming because the contractors were working under a State contract to repaint the bridges. OSHA charged that the company did not have proper scaffolding at the bridges exposing workers to falls, and in fact one worker was injured in June after falling from a scaffold at one of the bridges. Because of these repeat violations, Continue reading Unsafe Workplaces Equal More Injuries.

Slow Recovery Affects Workers’ Compensation Benefits and Costs

A Press Release by the National Academy of Social Insurance

 

WASHINGTON, DC – Workers’ compensation benefits declined to $57.5 billion in 2010 according to a report released today by the National Academy of Social Insurance (NASI). The drop in workers’ compensation benefits was largely due to a 2.1 percent drop in medical benefits for injured workers. Employers’ costs for workers’ compensation also fell by 2.7 percent in 2010. As a share of covered wages, employers’ costs in 2010 were the lowest in the last three decades.

 

“As a share of covered wages, employers’ costs in 2010 were the lowest in the last three decades.”

 

“Employers’ costs as a percent of payroll declined in 43 jurisdictions,” said John F. Burton, Jr., chair of the study panel that oversees the report. “This decline is probably due to the slow pace of the recovery, with many jurisdictions still experiencing relatively high unemployment rates.”

 

Workers’ Compensation Benefits, Coverage, and Costs, 2010
Total

2010

Change   Since 2009 (%)

Covered workers (in thousands)

124,454

-0.3%

Covered wages (in billions)

$5,820

2.6%

Benefits paid (in billions)

$57.5

-0.7%

Medical benefits

$28.1

-2.1%

Cash benefits

$29.5

0.7%

Employer costs (in billions)

$71.3

-2.7%

Per $100 of Covered Wages

2010

Change   Since 2009 ($)

Benefits paid

$0.99

-$0.03

Medical benefits

$0.48

-$0.03

Cash benefits

$0.51

-$0.01

Employers’ costs

$1.23

-$0.06

Source: National Academy of Social Insurance, 2012.

 

The new report, Workers’ Compensation: Benefits, Coverage and Costs, 2010, is the fifteenth in the series that provides the only comprehensive data on workers’ compensation benefits for the nation, the states, the District of Columbia, and federal programs. 

 

“This report represents the first time the Academy has released employers’ costs by state.”

This report represents the first time the Academy has released employers’ costs by state. For a table showing employers’ costs for all fifty states and the District of Columbia, refer to Table 12 (page 34).

Most states reported a decrease in the number of workers covered but an increase in covered wages between 2009 and 2010. During the same period, the total amount of benefits paid to injured workers declined in 26 jurisdictions and increased in 25. As a share of payroll, benefits paid to injured workers fell by three cents to $0.99 per $100 of payroll in the nation.

The share of medical benefits for workers’ compensation has increased substantially over the last 40 years. During the 1970s medical benefits nationally accounted for 30 percent of total benefits, whereas in 2010 the share of benefits paid for medical care was almost 50 percent. Experts attribute this trend to the rising cost of health care.

Should your doctor have access to surveillance videos of you?

Today’s post comes from guest author Charlie Domer from The Domer Law Firm. It is particularly relevant now, at a time when we are seeing a spike in the number of cases where surveillance video is being used to bring claims to a halt here in Washington State.

A dozen attorneys in Montana representing injured workers made headlines petitioning their Supreme Court to stop State fraud investigators sharing surveillance videos with doctors of worker’s compensation claimants. About 14,000 Montana residents are covered by the State Fund and the Fund’s Investigative Unit conducts video surveillance on about 500 claimants each year and shows the videos to claimants’ treating physicians. This practice raises questions about physician-patient privilege and patient privacy.

In Wisconsin and most other States, the physician-patient privilege is waived by an employee who reports a work-related injury. The waiver only extends, however, to any condition or complaint reasonably related to the work injury. Considerable debate sometimes arises over which treatment records are reasonably related to a claim. A broken toe, for example, is not likely relevant to an asthma condition but a prior Hepatitis-C claim may be. Employers and insurers may attempt to obtain records from a medical provider without a release, and practitioners must provide reports to the employer, insurer, employee, or Worker’s Comp Division within a reasonable time after written request.

The Fund’s Investigative Unit conducts video surveillance on about 500 claimants each year and shows the videos to claimants’ treating physicians… In Wisconsin and most other States, the physician-patient privilege is waived by an employee who reports a work-related injury. The waiver only extends, however, to any condition or complaint reasonably related to the work injury. 

Insurance carriers and employers also defend or deny worker’s compensation claims through surreptitiously obtained videos. The videos Continue reading Should your doctor have access to surveillance videos of you?